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Clincal Science Tips and tricks to survive in the Clinical Science, share your clinical rotaion and lot more

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Interesting EKG-diagnose it - 12-08-2006, 09:49 PM

QRS is inverted in I, while upright in AVR. If there was only QRS inversion in I, you would obviously diagnose it as Right axis deviation. However, there is also P inversion in I. What is the diagnosis? I give you hint: Inverted QRS and P waves in lead I suggest either dextrocardia or it could be due to wrong placement of limb leads- right to left, left to right. So what is ur diagnosis?
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Re: Interesting EKG-diagnose it - 13-08-2006, 08:05 AM

QRS is inverted in I, while upright in AVR. If there was only QRS inversion in I, you would obviously diagnose it as Right axis deviation. However, there is also P inversion in I. What is the diagnosis? I give you hint: Inverted QRS and P waves in lead I suggest either dextrocardia or it could be due to wrong placement of limb leads- right to left, left to right. So what is ur diagnosis?

Look at the precordial lead-this precordial lead will tell you the correct answer. Just one simple rule: If R wave progression is normal, it is wrong placement of limb leads (limb leads are reversed), and if R wave progression is abnormal i.e. if there is R wave regression then it is dextrocardia. And now what you see in this EKG? R wave regression in precordial leads?? Yes, here you are--this is a case of Dextrocardia. Now take out ur steth and start auscultation--but dont start from right side of the chest, ur boss will kick ur ----

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